What is an upper GI (UGI) with small bowel series?

An upper gastrointestinal (UGI) with small bowel series is an x-ray exam that shows the gastrointestinal tract (the part of the body that food passes through as it is digested) and the entire small intestine. A UGI helps the radiologist (imaging doctor) to look at your child’s gastrointestinal tract, which includes the esophagus (swallowing tube), stomach and small intestine, are working. The UGI typically lasts 2-3 hours, sometimes more.

Why does my child need a UGI?

An UGI with small bowel series exam helps find the cause of conditions such as swallowing difficulties, unexplained vomiting, abdominal (belly area) discomfort and indigestion (upset stomach).

Who performs the examination?

A pediatric radiologist and a pediatric-trained x-ray technologist (person who does x-rays on children will help you and your child during this procedure. At times, a child life specialist will also be present during your child’s procedure. A child life specialist helps your child cope with their hospital experience through age-appropriate play, distraction and explanations.

How can I prepare my child for the UGI?

Your child’s age will determine how you will prepare them. Toddlers and preschool-aged children require a very simple explanation of the procedure just before it begins. School-aged children and adolescents (teens and young adults) require a more detailed explanation of the procedure about 1-2 days in advance. This gives them time to ask any questions they might have prior to the exam. Above all, it is important to be completely honest with your child about the procedure.

How is a UGI performed?

Your child will need to have an empty stomach for the UGI. You will receive instructions on when your child should stop eating and drinking from the doctor who ordered the UGI exam before the date of your child’s exam.

  1. A pediatric x-ray technologist or a child life specialist will bring you and your child into the fluoroscopy room (room where the UGI is done). The x-ray technologist or the child life specialist will explain the UGI to you and your child.
  2. Your child change into a hospital gown. Once changed, the pediatric x-ray technologist will help your child onto the fluoroscopy table.
  3. Your child will be given a thick, white liquid called barium to drink, usually through a straw or bottle. This liquid helps the radiologist see the gastrointestinal system more clearly. Because barium does not always have a pleasant taste, your child can choose a chocolate, strawberry or vanilla flavoring to add to the barium to make it taste better*.
  4. The radiologist will move the fluoroscopy camera over your child. The camera will come close to, but not touch, your child. The radiologist will take x-ray pictures as your child swallows the barium liquid. Your child roll from side to side while the pediatric x-ray technologist takes x-ray pictures.
  5. When the barium liquid empties from your child’s stomach and the radiologist has seen enough of it pass through the small intestine, the UGI is complete. Then, the small bowel series will begin.
  6. Because the small bowel series tracks how long barium liquid takes to move through the entire small intestine, it usually takes 2-3 hours or more to complete. Your child may need to drink another cup of barium liquid to drink. Your child will need to finish this cup of barium within 30 minutes.
  7. You and your child will go back to the playroom. The x-ray technologist will take your child for an x-ray room every 30 minutes or so for x-ray pictures of their abdomen. The UGI is done when the contrast reaches the colon (last part of the large intestine).
  8. Once the UGI is done, your child may return to their usual diet as instructed by your doctor. It is a good idea to have your child drink more fluid for the day. It is normal for your child’s stools to look white due because of the barium.

*If your child has food allergies, it is important to let the radiology team know before the UGI.

What can I do to help my child during the examination?

You will be with your child during the entire UGI*. For some children, having a family member with them is comforting enough. Others may require additional support. The radiology team has toys, books and other items to help your child during the UGI.

*Please note: People who are pregnant and other children are not allowed in the fluoroscopy room.

What happens once the UGI is done?

The results of your child’s exam will be sent to the doctor who requested the UGI. Typically, your doctor will receive the results within 1-2 days of the UGI or sooner. Critical results are sent to the ordering doctor shortly after the UGI is complete.


If you have additional questions or concerns regarding the UGI with small bowel series, please contact the Pediatric Imaging child life specialist at 617-724-1153.

Rev. 5/2022. MassGeneral for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.